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中华结直肠疾病电子杂志 ›› 2023, Vol. 12 ›› Issue (03) : 177 -181. doi: 10.3877/cma.j.issn.2095-3224.2023.03.001

侧方淋巴结清扫专栏

直肠癌侧方淋巴结清扫的手术指征及并发症的防治
潘欢欢, 贺鑫怡, 王松胜, 朱喆, 厉周()   
  1. 510260 广州,南方医科大学珠江医院普外科
  • 收稿日期:2022-07-12 出版日期:2023-06-25
  • 通信作者: 厉周
  • 基金资助:
    广东省大学生科技创新培育专项资金(pdjh2021a0094); 中国青年创新创业项目支持计划(PDJH2021008)

The surgical indication and the prevention of complications of lateral lymph node dissection

Huanhuan Pan, Xinyi He, Songsheng Wang, Zhe Zhu, Zhou Li()   

  1. Department of General Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou 510260, China
  • Received:2022-07-12 Published:2023-06-25
  • Corresponding author: Zhou Li
引用本文:

潘欢欢, 贺鑫怡, 王松胜, 朱喆, 厉周. 直肠癌侧方淋巴结清扫的手术指征及并发症的防治[J]. 中华结直肠疾病电子杂志, 2023, 12(03): 177-181.

Huanhuan Pan, Xinyi He, Songsheng Wang, Zhe Zhu, Zhou Li. The surgical indication and the prevention of complications of lateral lymph node dissection[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(03): 177-181.

直肠癌常因侧方淋巴结转移复发,外科手术是最重要的治疗手段。但在治疗上,是采用侧方淋巴结清扫作为标准治疗,还是将其当作远隔转移而以放化疗为主要治疗手段,东西方学者观点不同。侧方淋巴结清扫手术操作复杂,可能引发严重的术后并发症,加上新辅助治疗后可能出现的组织水肿及纤维化,手术难度进一步增大,技术广泛开展受到了限制。因此,控制术后并发症的发生,把握手术指征,是侧方淋巴结清扫治疗策略发展中不可忽视的问题。

Lateral pelvic lymph node metastasis is the main cause of the recurrence of rectal cancer, and surgery is the main treatment method. However, in terms of treatment, whether to regard lateral lymph node dissection as the standard treatment, or to treat lateral lymph node metastasis as distant metastasis with radiotherapy and chemotherapy as the main treatment method, Eastern and Western scholars hold different views. In addition, due to the complicated operation of lateral lymph node dissection, it may bring serious postoperative complications. Besides, tissue swelling and fibrosis may occur after neoadjuvant therapy, which also increase the difficulty of the operation. As a result, the deployment of the technology is limited. Therefore, controlling the occurrence of postoperative complications and evaluating the surgical indications are too important to be ignored in the development of the lateral lymph node dissection treatment strategy.

图1 直肠癌侧方淋巴结清扫术中可能损伤的结构(绘图:朱喆)
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